Decisions about caring for people at the end of life remain among the most significant and difficult decisions facing families today. The Dutch model for euthanasia is a meaningful effort to help families deal with these decisions and therefore deserves the careful observation and analysis that it is receiving.

Officially the Dutch model relies on families and family physicians to reach decisions about euthanasia. That does not entirely avoid the future possibility that someday, the Dutch national health care program, or some other government's program - say, in the U.S. - may actually prescribe euthanasia as a matter of law or regulation, in order to save money. That’s my idea of the ultimate death panel. Brave New World indeed.

History shows that governments insist on participating in financial decisions when they are paying for the outcomes. In other words, a government health care program cannot pretend to be a fair and impartial third-party, because it is an interested participant in the outcome. It's a conflict of interests that won't go away.

How can America avoid that possible future? For one thing, the public cannot afford to rely on lawmakers; we must do our best to watch what other governments - such as the Netherlands - are doing. And for another, we must watch what our own government is doing.